Ageing, Health Status and Determinants of Health Expenditure WPVIII: Development of Scenarios for...

Ageing, Health Status and Determinants of Health Expenditure

WPVIII: Development of Scenarios for Health Care Expenditurein Germany

Dr. Erika Schulz

Erika Schulz28.06.2007

Estimation of Health Care Expenditure

– Based on data collected in WPVI– Estimations of determinantes of HCE carried out by IPH Denmark– Estimation model created by NIESR– and– AWG data for

• Gdp (growth rates)

• age0_5

• age65_74

• age75_

• le65f

• le65m

• unemp

• Mortinterpol (calculated based on population and death)


Development of total population in Germany

Demographic development in Germany until 2050

74

75

76

77

78

79

80

81

82

83

84

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

In M

ill.


Share of the young (0-5) and old (65-74, 75+) population in Germany

4

6

8

10

12

14

16

18

20

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

in %

age0-5 age65-74 age75+


Development of the crude death rate in Germany

1,0000

1,1000

1,2000

1,3000

1,4000

1,5000

1,6000

1,7000

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

dea

th p

er 1

000

inh

abit

ants


Development of life expectancy at age 65 in Germany

17

18

19

20

21

22

23

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

yea

rs


Influence of socio-economic variables (Model 0)

Variable Value in 2003 Value in 2050 Projected Share of Difference Base run Health Spending from

in 2050 (%GDP) BaseBase 13,3

GDP 24103,07 47328,85 12,95 -0,35GDP (1,5%) 13,37 0,07

AGE0-5 5,6 4,69 13,33 0,03AGE65-74 9,96 11,98 13,63 0,33AGE75+ 7,54 18,5 25,86 12,56

AVELE65 18,55 21,8 9,22 -4,08MORTALITY 1,03 1,62 9,23 -4,07

UNEMPL 9 7 12,93 -0,37ALCCON 10,64 8,41 13,23 -0,07PUSHES 79,36 80,97 13,15 -0,15

AWG





GDP 24103,07 47328,85 13,51 0,47GDP (1,5%) 13,07 0,03

AGE0-5 5,6 4,69 13,09 0,05AGE65-74 9,96 11,98 13,34 0,3AGE75+ 7,54 18,5 24,3 11,26

AVELE65 18,55 21,8 9,23 -3,81MORTALITY 1,03 1,62 9,02 -4,02

UNEMPL 9 7 12,55 -0,49ALCCON 10,64 8,41 12,99 -0,05PUSHES 79,36 80,97 12,89 -0,15

AWG


Influence of policy variables (Model 0)


in 2050 (%GDP) BaseBeds 6,17 4,88 13,3

Value in Base Value in 2050Run Alternative

SalaryGP 0 1 16,26 2,96CapGP 0 1 17,03 3,73

GlobalHO 0 1 13,57 0,27CaseHO 0 1 13,48 0,18

CoPayGP 0 1 13,3 0CoPayHO 1 0 14,47 1,17

FreeGP 1 0 9,7 -3,6FreeHO 1 0 13,39 0,09




in 2050 (%GDP) BaseBeds 6,17 4,88 13,04


SalaryGP 0 1 16,06 3,02CapGP 0 1 16,79 3,75

GlobalHO 0 1 12,97 -0,07CaseHO 0 1 12,88 -0,16

CoPayGP 0 1 13,04 0CoPayHO 1 0 14,17 1,13

FreeGP 1 0 9,63 -3,41FreeHO 1 0 13,16 0,12


Influence of restrictions in long run income elasticity

Restriction on +1% s.d. of Health Care -1% s.d. of AWGlong run income HCE in 2050 Expenditure HCE in 2050 Scenarios

elasticity (% GDP) 2050 (%GDP) (% GDP)

Unrestricted 15,72 13,3 11,261,0 15,33 13,04 11,11,1 15,71 13,32 11,291,2 16,28 13,71 11,54


Table 6-7. The Impact of Restrictions on the Demographic Parameters on the Projected Share of Health Expenditure in 2050

Model GDP

Elasticity AGE65-

74 AGE75+ AVELE65 MORT +1 S.D

Health Expenditure in 2050 (%

GDP)

-1 S.D

0 1.095 -0.015 -0.060 0.120 0.710 15.91% 13.46% 11.39% 1 0.923 0.024 0 0.089 0.713 28.08% 23.81% 20.19%

2S 1.095 -0.015 -0.060 0.120 0.313 12.42% 10.86% 9.50% 3S 1.095 0 0 0 0.313 16.47% 13.93% 11.79% 4S 1.095 0.009 0.020 0.130 0.672 40.14% 35.14% 30.76% 5S 1.095 0.009 0.020 0 0 17.82% 15.83% 14.23% 6 1 -0.013 -0.057 0.113 0.717 15.46% 13.16% 11.20% 7 1 0.024 0 0.093 0.707 29.53% 25.06% 21.27%

8S 1 -0.015 -0.060 0.120 0.313 11.57% 10.13% 8.86% 9S 1 0 0 0 0.313 15.45% 14.13% 12.93%

10S 1 0.009 0.020 0.120 0.710 37.40% 32.77% 28.70% 11S 1 0.009 0.020 0 0 16.42% 14.76% 13.28%

Note: Boldface entries indicate numerical values of restrictions. Other entries are the long-run coefficients implied by the restrictions.


Results for Denmark


Development of total population in Denmark

Demographic development in Denmark until 2050

5,25

5,3

5,35

5,4

5,45

5,5

5,55

5,6

5,65

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

In M

ill.


Share of young (0-5) and old (65-74, 75+) population in Denmark

4

6

8

10

12

14

16

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

in %

age0-5 age65-74 age75+


Development of the crude death rate in Denmark

1,0

1,1

1,1

1,2

1,2

1,3

1,3

1,4

1,4

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

dea

th p

er 1

000

inh

abit

ants


Development of life expectancy at age 65 in Denmark

16

17

17

18

18

19

19

20

20

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

2026

2028

2030

2032

2034

2036

2038

2040

2042

2044

2046

2048

2050

Yea

rs





GDP 28745,1 62121,79 8,64 -0,23GDP (1,5%) 8,92 0,05

AGE0-5 7,44 6,02 8,91 0,04AGE65-74 7,8 10,32 9,45 0,58AGE75+ 7,03 14,63 13,39 4,52

AVELE65 16,7 19,54 6,42 -2,45MORTALITY 1,07 1,34 7,33 -1,54

UNEMPL 5,4 4,26 8,73 -0,14ALCCON 9,55 9,89 8,88 0,01PUSHES 82,94 73,9 9,47 0,6

AWG





GDP 28745,1 62121,79 8,87 0,39GDP (1,5%) 8,58 0,1

AGE0-5 7,44 6,02 8,54 0,06AGE65-74 7,8 10,32 8,92 0,44AGE75+ 7,03 14,63 12,47 3,99

AVELE65 16,7 19,54 6,25 -2,23MORTALITY 1,07 1,34 7 -1,48

UNEMPL 5,4 4,26 8,3 -0,18ALCCON 9,55 9,89 8,49 0,01PUSHES 82,94 73,9 9,07 0,59

AWG




in 2050 (%GDP) BaseBeds 3,38 2,67 8,87


SalaryGP 0 1 10,84 1,97CapGP 0 1 11,36 2,49

GlobalHO 0 1 9,05 0,18CaseHO 0 1 8,99 0,12

CoPayGP 0 1 8,87 0CoPayHO 0 1 8,15 -0,72

FreeGP 1 0 6,47 -2,4FreeHO 1 0 8,93 0,06




in 2050 (%GDP) BaseBeds 3,38 2,67 8,48


SalaryGP 0 1 10,45 1,97CapGP 0 1 10,92 2,44

GlobalHO 0 1 8,43 -0,05CaseHO 0 1 8,37 -0,11

CoPayGP 0 1 8,48 0CoPayHO 0 1 7,81 -0,67

FreeGP 1 0 6,26 -2,22FreeHO 1 0 8,56 0,08


Influence of restrictions in long run income elasticity - Denmark

Restriction on +1% s.d. of Health Care -1% s.d. of AWGlong run income HCE in 2050 Expenditure HCE in 2050 Scenarios

elasticity (% GDP) 2050 (%GDP) (% GDP)

Unrestricted 10,13 8,87 7,761,0 9,7 8,48 7,421,1 10,14 8,89 7,791,2 10,64 9,34 8,2


Table 3-7. The Impact of Restrictions on the Demographic Parameters on the Projected Share of Health Expenditure in 2050

Model GDP

Elasticity AGE65-

74 AGE75+ AVELE65 MORT +1 S.D

Health Expenditure in 2050 (%

GDP)

-1 S.D

0 1.095 -0.015 -0.060 0.120 0.710 10.13% 8.87% 7.76% 1 0.923 0.024 0 0.089 0.713 13.31% 11.62% 10.15%

2S 1.095 -0.015 -0.060 0.120 0.313 8.93% 8.00% 7.16% 3S 1.095 0 0 0 0.313 10.51% 8.42% 6.74% 4S 1.095 0.009 0.020 0.130 0.672 18.88% 16.75% 14.86% 5S 1.095 0.009 0.020 0 0 11.35% 10.20% 9.16% 6 1 -0.013 -0.057 0.113 0.717 9.70% 8.48% 7.41% 7 1 0.024 0 0.093 0.707 14.01% 12.28% 10.77%

8S 1 -0.015 -0.060 0.120 0.313 8.32% 7.47% 6.71% 9S 1 0 0 0 0.313 9.51% 8.56% 7.70%

10S 1 0.009 0.020 0.120 0.710 17.58% 15.65% 13.93% 11S 1 0.009 0.020 0 0 10.57% 9.53% 8.59%

Note: Boldface entries indicate numerical values of restrictions. Other entries are the long-run coefficients implied by the restrictions.

Ageing, Health Status and Determinants of Health Expenditure WPVIII: Development of Scenarios for...

Documents

Transcript of Ageing, Health Status and Determinants of Health Expenditure WPVIII: Development of Scenarios for...